CQI Projects
Continuous Quality Improvement (CQI) Projects:
Based on the ACGME Residency Review Committee (RRC) requirements, residents have to complete CQI projects which address the six competencies in Internal Medicine training- particularly the tough ones: “practice-based learning and improvement” and “system-based learning”. CQI project is a scholarly activity that seeks to improve health care delivery and patient care. The Director of Research gives a didactic lecture to all residents on the importance of quality improvement projects and on how to run these projects.
In formulating a QI project, the residents work in teams and they start with three questions: 1. What are we trying to accomplish? What outcome we want (clear, finite, measurable outcome). 2. How will we know if a change is an improvement? ) Is the outcome clear, finite, measurable?) 3. What change will result in an improvement? Then residents implement a PDSA cycle (Plan, Do, Study, Act), the analytical continuous improvement management method to assess a problem, measure; intervene to change, and measure outcome or change. The PDSA cycle is a problem-solving tool that constitutes the core component of the continuous improvement projects. It measures the effects of small changes incurred on a clinical or organizational/clinical problem, and it is repeated over several cycles until the interventions achieve the desired goals.
Here are the steps of the PDSA cycle:
• PLAN phase involves identifying possible problems preventing you from achieving your goal and potential solutions to the problems. It analyzes the causes of problems and identifies opportunities for improvement. This phase determines process changes needed to improve outcomes and includes baseline data measurement.
• DO phase is focused on implementing process solutions or improvements once the baseline data is collected.
• STUDY phase involves reviewing results by evaluating the effectiveness of the intervention by collecting follow-up data, checking if target goals are met, and, if not, making necessary changes to interventions.
• ACT phase is focused on implementing a modified or refined intervention and/or implementing additional interventions to achieve established goals.
QI PROJECTS PRESENTED AT DMC-QuESST:
Project: Ambulatory Clinic Follow-up and Discharge from Hospital
Authors: Paramveer Singh; Anisha Pahwa; Rohan Naik; Rana Ismail; Roshini Moses; David Sykes; Joseph Clairborne; Mohammed Ahmed; Mohanned Alhassani; E.M. Malitha S. Hettiarachchi
Project: Improving Continuity of Care in a Suburban Detroit Ambulatory Resident’s Clinic
Authors: David Chaar, Wan Yee Kong, Keval Shah, Xin Yang, Eleanor Yu, Akshay Sharma, Rana Ismail, Malitha Hettiarachchi
Project: Hospitalization of Patients with Syncope Secondary to Orthostatic Hypotension: Length of Stay Investigated
Authors: Ayman Abulawi; Rana Ismail; Heba Mahmoud; Marcel Eadie; Aaron Greenberg; LaTorya Ellison; Ghadeer Fatani; Mohamed Siddique, MD.
Project: Comparison of Antibiotic Treatment Choice between Infectious Disease Physicians and Other Physicians in an Inpatient Setting at a Tertiary Care Community Hospital
Authors: Hamid-Reza Moein; Ali Hajj Ahmad; Jay Liu; Suganya Chandramohan; Wasif Hafeez, MD
Project: Compliance with Guidelines in Asymptomatic Bacteriuria (ASB): The Provider’s Role in Testing and Treatment
Authors: Lekiesha Porter; Amin Marji; Sidhant Pamnani; Jay Liu; Sara Razmjou; Rana Ismail; E.M. Malitha S. Hettiarachchi, MD
Project: Physicians' Attitude and Knowledge Regarding Antibiotic Use and Resistance in Ambulatory Settings
Authors: Suganya Chandramohan; Amanda Harris; Reda Ahmad Awali; Glenn Tillotson, PhD, FIDSA; Teena Chopra, M.D., M.P.H.